Ethmoid Sinus Surgery

Abstract

The complex, unique, and variable anatomy of the ethmoid sinuses makes ethmoidectomy a challenging surgery even for the well-experienced sinus surgeon. For this reason, developing a systematic approach to management of patients with ethmoid sinus disease is paramount. Surgeons should be aware of the complex, unique, and variable anatomy that may exist in this confined area. This surgery can be performed safely and effectively using the methods and precautions outlined in this chapter. In order to perform complete surgery and avoid complications, surgeons should develop a systematic way to review preoperative CT imaging to detect anatomic variations that may predispose the surgeon to surgical misadventures. The surgeon must proceed systematically from landmark to landmark intraoperatively and not proceed if anatomic uncertainty exists. This chapter will review the complex anatomy of the ethmoid sinuses, discuss clinical indications for ethmoid surgery, and describe a stepwise, systematic technique which allows the surgeon to perform a safe and successful surgical ethmoidectomy.